HOSPITAL HOUSEKEEPING SERVICES

PRADNYA KARDE DR. SULAKSHANA

INTRODUCTION
The technological development in the modern era and knowledge explosion has revolutionized the concept of care in the hospital. Good housekeeping has got the direct effect on the health comfort and morale of patient, doctors, health care workers and visitors. This is the area which serves the broader social need and has a history of rapid changes in function and organization. The housekeeping era started in the middle of the 17th century George Washington, considered housekeepers indispensible in his household, in order to relieve Mrs. Washington. Florence nightingale also emphasized Housekeeping as a specialty on its own.

Continued The hotel industry initiated with the housekeeping services. Later the concept of housekeeping got incorporated in health care set up. Hospital Administrators/ Trustees/ Board of Directors felt in the middle of the 20th century that the hospital housekeeping is the specialty on its own. The house keeping departments work has advanced rapidly in recent years and requires knowledge, skill and understanding of management tools. Good housekeeping has proved to prevent and control hospital acquired infection, and thus reducing the Average Length of Stay (ALOS), which in turn reduces the drug cost and also prevents lots of suffering.

Continued Its an activity upon which all the health giving services of the hospital depend. The work of housekeeping is simplistic but when one considers maintaining a house of several hundreds of rooms and numerous public areas, the task becomes gigantic.

DEFINITION
Housekeeping department has the duty of cleaning and sanitation of all the hospital. The hospital housekeeping function is defined to include all labor transportation, equipment material supplies management coordination and supervision required to perform the hospital housekeeping services, Its the department which is the non revenue producing service department, but has a widest scope in the hospital as it maintains the image of the hospital.

OBJECTIVES
To Achieve the aesthetic appeal of the hospital, Achieve maximum efficiency possible in the care and comfort of the patient and the smooth running of the hospital, To provide quality health care by personalized services, To increase public demands and awareness- need for public image of the highest degree of hospital To improve patient care, to control and prevent hospital acquired infections, To develop highest specified standards of property maintenance of the hospital. To ensure high standards of cleanliness and general upkeep in all the areas.

STRUCTURE
PHYSICAL STRUCTURE
LOCATION:

Housekeeping department serves for all the areas and departments of the hospital, thus it needs to be centrally located and close to vertical transport system to facilitate easy movement of materials and equipment used in housekeeping. Office for the Housekeeping Manager

STRUCTURE
PHYSICAL STRUCTURE
LOCATION:

Clerical work area Chiefs office keepers desk and bulletin board to put up daily duty charts and other housekeeping information. Store room for housekeeping equipments and materials

Continued Housekeeping closets on the floors of the hospital for the with the space and shelves for housekeeping equipment and materials, an trolleys as a mailer of routine, supplies for daily use should be delivered to the respective closets directly.

Housekeeping Control Desk: The housekeeping desk is the nerve centre for the entire department and its efficiency determines the smooth functioning and effectiveness of housekeeping. It is the focal point for dissemination of information and communication to various points in the housekeeping department as well as to other departments for better coordination.

ContinuedTHE AREA OF CONTROL DESK MUST HAVE: INFORMATION BOARD: Duty chart for housekeepers and sweepers Cleaning schedules Hospital staff room accommodation Other general information and important announcements. KEY BOARD: Patient room Key office room Entrance Keys Others

CONTINUEDREGISTERS FILES FORMS: Housekeeping equipments and supplies list Attendance register for sweepers Request form for supplies and equipments from stores Request form for repairs to be carried out in other wards Inventories of supplies and equipments Checklists for patient rooms Year planning calendar Inventory for furniture and furnishing Inventory of linen Personnel data Progress reports

ORGANIZATIONAL STRUCTURE
HOUSEKEEPING MANAGER ASSISTANT MANAGER CHIEF HOUSE KEEPER SUPERVISORS LEADERS (MUKADAM) HOUSEKEEPING TRAINEES WORKERS SWEEPERS GARDENERS

Qualities of Housekeeping manager

Basic knowledge of health care hygiene and sanitation Ability to plan, administer and develop all phases of a comprehensive housekeeping program that will provide a suitable environment for the institutions medical and administrative activities Demonstration of personal qualities of leadership and skill in coordinating a major activity within the administrative program General working knowledge of cleaning operations and interior decoration

Qualities of Housekeeping manager

Ability to assign, supervise and evaluate the work of subordinate supervisors and their personnel Ability to develop the departmental budget and to direct the expenditure of monies.

HOUSEKEEPING MANAGER
Function: Collaborate with other departments to ensure delivery of quality services Interview, select, train, evaluate and counsel staffs of housekeeping department Instruct and advice staffs on changes in policies, procedures or working standards Listens to the problems if any of the housekeepers, sweepers and try to solve them Conduct meeting to exchange ideas and solve problems

Continued Attend to the complaints and queries if any or other departments and patients related to housekeeping services Rounds to inspect housekeeping services in work area Conducts hospital housekeeping surveillance audits Work closely with the administrators on day to day

housekeeping requirements,
Training induction and on job training of housekeeping staffs

Continued Monitor departmental activities to ensure maximum

efficiency in the services being provided Assist in developing, delegating and monitoring departmental goals, objectives and programs to ensure timely completion Reporting to the management

Interdepartmental Relationship
Maintenance Human Resource and Personnel Dept. Laundry,

Security

Housekeeping

Kitchen and Catering

Civil, BMED and Other Departments Stores

Nursing

ASSISTANT MANAGER
Daily rounds to inspect housekeeping services in work area Assisting the Housekeeping Manager in administrative work Monitor the use of supplies and equipments and prepare a monthly purchase request and issue request as and when required or as per the hospital protocol
Reports to the housekeeping managers

CHIEF HOUSE KEEPER

Functions: Cooperates with the staffs of other departments Deployment supervision control and training of the staffs Checks the standards of cleaning of all the areas in the hospital Keep inventories and records of the equipments and supplies Supervise and instruct the sweepers on day to day activities Enhance the dcor of different areas of the hospital

Continued
Control and supervision of the work in linen room Train new recruits' Check all safety items on the allotted floors Record all lost and found items as per laid down norms
Reports to the asst. housekeeping managers.

SUPERVISORS
Organization of work, planning of task
Directing the work of those responsible to him Co-ordinate the resources under his direction

Control workers and resources

Supervising and guiding the housekeeping staffs and getting quality work done Evaluate the job performance of HK staffs Identifying the training needs and planning the same

Mukadam (Leaders)
Their main responsibility is to allocate the duty And supplying adequate staffs to the respective areas Arranging the workers in case of shortage. Cooperates with the staffs of other departments

SWEEPERS

Functions: Receive the allocation of the floor and area of cleaning Clean the rooms at least

twice in a shift
Clean the toilets and bathrooms of the allotted department at least twice in a shift

Continued -

Follow instruction and cleaning procedures given by the supervisor Use supplies economically Maintain polite and dignified attitude towards patient Report and hand over all the lost and found articles to the supervisor Reports to : Housekeeping Manager

GARDENER
Function:

Clean and maintain the garden Taking care of newly cultivated plants Water and prune the plants
Reports to: Housekeeping Supervisor

Communication
Factors to be considered: workers should understand clearly what is expected of them Unwanted actions should be avoided- use simple and clear languages Adopt demonstration methods to explain the work procedures, Proper job specification Two way communication is essential to avoid miss understanding of the work procedure Guidelines given to the workers should neither be over commanding, nor easy. They should be moderated. New policies and procedures should immediately be explained to the workers and their queries should be clarified,

Selection criteria for housekeeping staff

Edu. Qualification: Min. 12th pass

Age:

18 to 20 yrs (as per hospital policy)

Health and appearance: He/ She should have a good health and should clear the medical fitness test.

Responsibilities of the housekeeping department

Responsibilities

Direct Responsibilities

Indirect Responsibilities

 Direct:

Daily cleaning Periodic cleaning.

Ensuring clean

linen supply Bed making, dusting

Continued Pest control Pest Control is a major job of the Housekeeping Department. No matter how clean one keeps ones surroundings, you cannot avoid pests. It is not only embarrassing but also speaks badly of a hospital where one sees rats, cockroaches, and lizards running around. Thus a protocol should be there for regular pest control and it has to be supported by a proper documentation

Continued Preventing spread of infection Creating an aesthetically pleasant atmosphere Waste constitutes a problem, the size of the problem varying with the size of the institution, because waste must be disposed of economically and efficiently, and in a sanitary way.

Continued Safety against fire, prevention of crosscontamination by infectious materials, odor control, and pest control are all included in waste disposal procedures. A carefully planned program of waste disposal will safeguard not only personnel and patient but also the community.

Continued Safety and security of the hospital Gardening Making necessary arrangements for the meetings, programs and workshops.

Continued Indirect responsibilities Saving electricity by switching off the lights Ensuring economical use of supplies to save cost Maintaining helpful and courteous caring attitude towards patients and visitors Promoting safety and reporting dangerous conditions whenever observed Maintaining harmonious working relation with other departments

In service education/ Training

The basic training schedule for HK staffs should be
planned for a specific period and should cover all aspects of housekeeping. After the training staffs should be evaluated on their understanding of the housekeeping services.

After the evaluation well trained staffs should be

allocated to appropriate areas.

The training schedule can include following topics

Introduction to housekeeping General rules and regulation Hospital work culture and values Housekeeping and patient relationship-better communication skills Job description Orientation Ward management Water tank cleaning and chlorination Importance of checklist Safety at work place

 General infection control protocols relevant to them e.g waste segregation, handling soiled and infected linen etc, Protocols on safety related to occupational exposure to blood and body fluid. E.g Needle stick injuries Waste segregation protocol of hospital Spill management (blood and mercury) Housekeeping procedures like
Bed making Dusting Cleaning Disinfection e.g Bacillocid, Sodium hypochlorite, Ecoshield etc. Patient transportation Lift cleaning etc,

Continued-

Work schedule
Standard cleaning Planning schedule Frequency of cleaning Areas and zoning
High risk areas eg. OT Transplant units requires highest possible standards of cleaning Medium risk areas e.g Kitchen & toilets requires high standard of cleaning Low risk areas e.g Office waiting areas, coorridors requires good standard of cleaning

Usage area Cleaning agent Dilution Time for cleaning agent to usage Floor,tiles,waetergent 20ml,5 litre,8gm/wash basin/toilet Direct T Toilet close all stain removal Harpic No dilution Direct Once a da Mopping the Cleaning the toilet Pursue 18ml/ litre Direct T Septic tank-lkg/washA water tank-500gms/wash Bleaching powder 2 mins Septic tank weekly Water tank-monthly Brass items Brasso Direct Special cleaning Drawers,wardrobes, sinks Napththalcnc balls Direct W Toilet odour control Odonil Direct Weekly Disinfections Dettol 100ml./ 5litre Direct Daily

Handling the difficult workers

Find out the reasons for the problem- health, personal problems or problem with the work procedures Arrange refresher training if required Frequently monitor and supervise the work Ask them to repeat the work if found unsatisfactory Motivate him to adopt new procedures and techniques adopted by the department Encourage the worker through incentives and bonus for festivals.

Continued Overtime Sick leave Change the duty when they require for genuine Reason Help him out with advance payments if they are in need Festival bonus

Welfare of the staff

To keep up the ,morale of the staff and to motivate them it is important to provide a good working atmosphere in the hospital.
Good working conditions Good working relationship and accessibility Incentive bonus Best employee award Statutory wedges(Provident fund, gratuity etc.) Medical facilities Sick leave and maternity leave Meals when on duty Proper work method

Housekeeping Manual
A good housekeeping department must have a written manual, which should include: The organization and brief outline of the hospital Rules like hours, leave, lunch, locker rules, safety rules etc, Special rules like training for specific areas Methods of supervision Housekeeping procedures Equipment supply and control of inventory.

 Separate budget to the department In future depending on the cost analysis if required these services can be outsourced.

Issues and Challenges

Maintaining effective interdepartmental relationship Effective communication Absenteeism Alcoholism Work allocation Conflict management Time management Procedures of housekeeping should be in conjunction with nursing procedures E.g. bed making after sponge bath Prevention of cross infection Noise pollution Variation in work methods at different work places

The

very first requirement in a hospital is that it should do the sick no harm.

---Florence Nightingale

THANK

YOU